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Resolution No CRA 38-18-1079/ RESOLUTION NO • .:;CRA:.:...:....._3_8_-1_8_-_1_0_7_9_ A Resolution authorizing a single-family residential rehabilitation program funding disbursement in the amount of $5,000 for flooring replacements 6016 SW 63rd Street. WHEREAS, the adopted redevelopment plan calls for the rehabilitation and preservation of the existing housing stock; and WHEREAS, to facilitate these objectives, the Agency established the single-family and multi-family residential rehabilitation programs; and WHEREAS, efforts have been made to prioritize repairs that affect health and safety; and WHEREAS, staff recently received a residential rehabilitation application from Ms. Monique Clark, a redevelopment area resident that qualifies using the Single-Family Rehabilitation program's income restrictions; and WHEREAS, the SMCRA resident has requested assistance with replacing the flooring in her home; and WHEREAS, based on the estimates submitted, $5,000 appears to be the most responsive and responsible; and WHEREAS, the Board desires to facilitate goals and objectives of the community redevelopment plan by facilitating housing rehabilitation and preservation initiatives in the SMCRA area. NOW THEREFORE BE IT RESOLVED BY THE COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF SOUTH MIAMI, FLORIDA THAT: Section 1. The South Miami Community Redevelopment Agency Board authorizes the Agency to enter into agreement in amount not to exceed $5,000 to replace flooring at 6016 SW 63rd Street, South Miami, FL; and charging the total amount to Account No. 610- 1110-564-99-30 (Residential Rehabilitation Account). Section 2. This resolution shall take effect immediately upon adoption. PASSED AND ADOPTED this 15th day of November, 2018. Page 1 0[2 Res . No.C R~ 38-18 -1 07 9 ATT ES T : A PPRO VED : 8 0a r d Vote: 7-0 Cha ir St oddar d : Yea Vice Ch air Har ri s: Yea Me mb e r We l sh : Yea M e mb e r Li e bm an: Ye a Me mb e r Gil : Y ~~ Me mb e r Jacks on : Yea M e mb er Ke ll Y:Yea Page 2 or2 Agenda Hem No:2. South Miami Community Redevelopment Agency Agenda Item Report Meeting Date: November 15, 2018 Submitted by: Evan Fancher Submitting Department: Community Redevelopment Agency Item Type: Resolution Agenda Section: RESOLUTIONS Subject: A Resolution authorizing a single-family residential rehabilitation program funding disbursement in the amount of $5,000 for flooring replacements 6016 SW 63rd Street. Suggested Action: Attachments: Clark Rehab Memo.pdf Rehab Grant Reso Clark 2018CArev.doc Monique Clark Rehabilitation Application 2018.pdf 1 I." CITY OF SOUTH MI AM I COMMUNITY REDE VELOPM EN T AGENCY OFFI CE OF THE EXECUT IVE DIRECTOR INT ER-OFFICE MEMORANDUM '''Iow,. "':t'f,~71.""'G {",." ,,~~:. 1-. '~ .• ' :no!'''''' To : Th r u: FROM : D ATE: SUBJECT: BACKGROU NO: REVENUE: The Honora bl e Ch airman & Mem b er s Q.\ t h e SM CRA Board Eva n Fanc he r, Execu t ive Di recto r rr ~'; James McCants, Pr ogra m s Coo r d in a1ol November 15, 20 18 Agenda Item No.: __ A r eso lu t io n autho r iz in g a sin gle-f amil y r es id entia l r e habilit ati o n pro gram f u n d in g di sbu r seme n t in t h e am ou nt of $5,000 for f loo r i ng r ep l ac em en t s 6016 SW 63rd St r ee t. The Sin gle-Fam il y Re h ab i l itati on Pr ogram o ffe r s gr ant fu ndi ng to pri va t e sin gl e-fam il y homeown e r s w i t h in th e So ut h M i ami Comm u nity Redeve l o pm e nt Ar ea (S M CRA) to incr ease t h e q u alit y of th e ex i st in g ho us in g stock. The prog r am pri o ri t izes ap pli ca ti o ns t h at add r ess hea l th, safety and we lfa re i ss u es o r wo ul d assist applicants w ho can at l eas t afford to car r y out r eha bi li tat ion act iv iti es. Mon i que Cla r k has req u ested assista n ce from our SMC RA sing l e-fam ily gr ant fu n ding i n t he amou nt o f $5,000.00 for floor i ng r enovat ions . Ms. Cl ar k nee ds t o r ep air h er fl oo r to d ea l wi th safety co n ce r ns. Median FAMILY SIZE 30 % 50% 80 % 100 % 120 % < E. LO W <-V. LOW <-LOW/MOD > 14 0% 1 $16 ,550 .00 52 7,550.00 $44 ,100 .00 $55 ,100.00 $66,120.00 $77 ,140.00 2 $18,900.00 $31 ,500.00 $50 ,400.00 $63 ,000.00 575 ,600 .00 S88 ,200.00 3 $21,250 .00 535,45 0.0 0 $56 ,700.00 $70 ,900 .00 $85 ,0 80.0 0 $99 ,260 .00 4 $25 ,100.00 $39 ,350 .0 0 $62 ,950 .00 $78 ,700 .00 594,440.00 S1 10,1 80.00 5 529,420 .00 S42 ,500.00 $68,000.00 $85 ,000.00 5102,000.00 $119 ,000 .00 6 $33,740.0 0 $45,650.00 $73 ,050.00 $91,300 .00 $109 ,560.00 $127 ,820 .00 7 S38 ,060 .00 $48,800 .00 $78 ,100 .00 $97 ,600,00 511 7,120 .00 $13 6,6 40 .00 8 $42 ,380.00 $51 ,950.00 $83 ,100 .00 $103 ,900 .00 $124 ,680 .00 S145 ,460 .00 M s. Cl ark qua li f i es f or th e prog r am 's inco m e spec if i ca ti o n s. Staff r ece i ved an d rev iewed t h e app li cation a lo n g with t hr ee bi ds to m ake th e r epair s. Th e lowest bid r ece ived was f or $5,0 0 0. St aff r eco mm e nd s a grant award fo r t h at amount. Th e tota l amount of $5,000 w ill be cha r ged to Account No. 610-1110- 564-99-30 (Res i de n t i al Reha b i li tatio n Account). Th e curre n t accoun t balance is $83 ,278.0 0. 2 APPLICANT'S NAME .DATE OF B IRT H 0 MAR ITA L STATUS (check one) WORK PHONE CO-APP LI CAN T'S NAME (Spouse) DATE OF B IRTH MAR ITAL STATUS (check one) MARR IED SEPARATED UNMARR IED (inclu des single , divorced & widow ed ) wh e n ca n yo u be rea ched . Anyll me I MARR IED SEPARATED n/a UNMARRIED (includes single , divorced & widowed) n/a WORK PHONE when can you be reach e d : HOME PHONE whe n can yo u be rea ched . CURRENT ADDRESS P r epo~ed ':Jy SOi. hlC page 1 of 5 5 Second Job $ Pension $ Social Security $ AFDClWe lfare S A li mony/Chi ld Support $ Co I n $ Interest from Savings $ Other income (exp lain) NAME OF LENDER PROVIDING YO UR MORTGAGE OR MORTGAGES Second Job $ Pens ion $ Social Sec urity $ AFDClWelfare $ A lim o ny/C hil d Support S Wori<ers ' $ sat ion Interest from Savings $ Other income (exp lain ) $ ADDRESS OF LENDER(S } vvv ... AJ :~· .. 0'-,...<.."(/./ ...... '. PHONE NUMBER OF LENDER ADDRESS OF PROPERTY TO BE REHABILITAT ED HOUSE N UMBER O F NUMBER OF INFORMATION BEDROOMS 3 BATHROOMS ASSESSED VA LUE OF PROPERTY AS DETERMINED BY THE MOST RECENT MIAMI-DADE COUNTY PROPERTY ASSESSMENT ?repared oy SDI, In c. <2... -{ C:(~ t .... ...... _ Il-I.:? HOUSE S IZE (SQUARE FEET) page 20' 5 6 This portion of the application can be provided after income guideline eligibility is determined. If can be completed by the applicant or by a licensed contractor. The format for this section shall not be preset but may be completed on a case-by-case basis. Prepared by SDI. Inc. page 3 of 5 7 ~aHy (Q)lf ~OlUJlfnJ MHOJmn ~ommUJIn~ty ~edeve~olPmellilt Agell'Dcy 5825 SW 68 th Street, Suite 4, South Miami, FL 33143, (305) 668-7236 NOTICE TO APPLICANTS This notice is provided to you as required by the Right fo Financial Privacy Act of 1978 and sto'tes that the South Miami Community Redevelopment Agency (SMCRA) has a right of access to financial records held by any financial institution in connection with the consideration or administration of the housing loan for which you have applied. Financial records inv~lving your transaction will be available to the SMCRA without further notice or authorization, but will not be disclosed or released to another government agency or private entity without you~ consent, except as required or permitted by law. Name Date " . \ 1'\\'\1 <i L( t 9--t:7 -11/ I Name (Co-Applicant) Date Prepared by SDI, Inc. page 4 of 5 8 Certiffica:~iO!l andi Sigr;<!tu~e I (We) hereby cer;;fy tnat all o f :he foregoing informalion is true and compiete 10 l'le besl o f my (our) knowledge, and hereby give my (our) permission 10 ihe C ily o f SOcJtn Miami Community Redevelopment Agency [SMCRA) (or any lende r acling an rhe Agency's behalf) 10 conduci furlhe r credit and financial investig ation , as deemed necessary to delermine elig ibil ity. Furthermore, I, (we) agree ia abid e by Ihe eligibility and program requirements set forth in connection with any opporJun ities which may be offe red to me (us) by Ih e SMCRA pursuan i to lhis applico l ion . I (we) underSTand thai false, inaccu rale, o r incomplete information in ihe foregoing applica ti on shail be cons id ered cause for me (us) to be disqualified from participation in the Residentia! Rehab ilita l ion Program for Single-Fami ly Homes, a program of Ihe SMCRA, and I (we) mus l immediately notify tr,e Agency of ony change in m y (our) income, sto lus of em p loy m enl prior to clos in g for re-ve ri fica ti on. I (we) fur l he r understand than on "Affidavit of No In come Change" must be signed prior to re ceiving any program benefits. I (We) hereby authorize the SMCRA or any lender ac l ing on the Agen cy's behalf to verify my post and present employmeni, pasl and presen' landlo rd info rma tion, pas; and p resent mortgage toans, and any olher c redit informaiion as needea . i (we) unders land a copy of Ih is form will a lso serve as aulh o ri zation. WARNING: Florido Stot ute 817 prov ides thot willtul false statements or m isrepresenta1ion concerning income and assets o r liabilities re io ii ng to ii nanciol ~ condi tion IS a misdemeano r o f the firsl degree ond IS punishable by fin es and l,~pnson:n t prov l d:~:der s::e 775082 or 775 :_ S ig~,a I Ur~ f A~Plicanl /' ( .. (, t'lL~ ( C"".(;! Dole Prepa:ec oy 5:::)', lr.c . Signa i ure 0 1 Co-App li cCint Dole page 5 015 9 To: Honorable Chai r and sMCRA Board Members From: James McCants Programs Coo rdin ator Community Outre ach Resolution Date: Jul y 9, 2018 Subject: Single -Family Rehabilitation Grant M oniq ue Clark A resolution authorizing a single-family residenti al rehabilitation program funding disbursement in the amount of $5,000.00 for Floor Til e posing safety concerns a significantly damaged roof replacem ent at 6016 SW 63 'd Street. BACKGROUND & ANA LYSIS The Single-Family Rehabi litation Program offers gra nt fundin g to pr ivate sing le-fam i ly homeowne r s within the South Mi ami Com munity Redeve lopment Area to increase the qualit y of the ex isting hou sin g stock . Th e pro gram priorit izes applications that address health, safety and we lfar e iss u es or would assist appl ica nt s w ho can at least afford to ca rry out rehabilitation activ ities. Mr. & Mrs. Lloyd Fields both ar e r eque stin g assistance of grant funding of $5,800.00 for Roo f repla cemen t . Mrs. Lloyd i s ha ving respiratory issue s; the mildew is affecting her co ndition . Mr. & Mrs. Lloyd Field s has tried to addre ss the problem the best they could. The p rop osed improvement is one of t he allowable activities under t h e prog r am, and Mr. & Mrs. Lloyd Fie ld s does meet the progr am's in come re strictions. RECOMMENDATION Your approval i s r ecommended. 10 Required DOcuments and check list All applicants requesting hptJsing rehabilitation are required to provide the following doctJrnentation with application before any work beBins. o Head of hou~ehold must be 62 or over or Disabled Picture 10, such as a driver's license o Social security cards (Of all persons appearing on the application Proof of age· and other documents related to family or household make-up including bIrth certiflcates, proof of divorce. o Proof of Disabllitv If it Is not evident Q • Proof of all income: including letter from Social Sec.urity, Veteran's Administration, pensions. employment, and ch!ld SUppOt1 payrnents_ lhe verification of Social Security benefits must be provided prior to scheduled appointment. US Veterans, US Reserves National Guar<i, Coast Guard Reserves must submit a'copy of the form. OD form 21.4 or (copy of Discharge certificate) until the copy of·OO form 214 is obtain Names, addresses, and phone numbers of at least two people to contad in case of emergency Signature and agreement not to sell home for up to three years from date of final repairs I eRA staff will provide Prepared by SDI. Inc. Jt 11 ~ "" II riority Fu";ding Consideration I ~ha l l Be Given for the Following I . C . r ome Rep a ir ategones: Priori ty i : i (OU CCl:OI1 of Munid p.l! Cooe V,olil lion5 t Pnor;ty 2: t A!J.1 lcmen l of Heal th and Safety Proble ms , In YOlir Home I Prionty 3: Provi sion oi Safe E1ec lll ca! and Mech erua! Sy5tcms ; Priod1) <1 Elimination 0 1 Wealhcr PenClr~lion !>ne nty 5: Imp'lOV't' Gene r;]1 Ho me al ll.l Sa\Kt.lnl\ Conritt j on~ ,'(;j!' ; . .;,. ,;.~Jj. ~~-~. '-"":';--"-1: .".~ ~';'. r ~''i~~ff.lw~~al~~bbM,ti~~(rtO rt tL ~';::--:: ':.. :tne~puth,.M~~i:c~; ,:: ~~~,~. '.,r ~ I', -. ~ -,,' " ,. -' .. :?-:\ "':::! -,:?~~~_SY~e!"Driy£;. ,,~<: '-:<' ~ft?, '.-'.'!: ""j30lli6&"1236 -:; .-, .. .,,>1' :; :-,:' .. ff;'I;.f,;:!: ~;,;" t 'f-"i"': 1~ ':iJ ~1·. ','·'-"i;-~~ The Follow i ng Home Repairs Lire Elig i b!e for Fund i ng Con si deration Correcfon of buildlfl9 code (omp 'i ~nce "';cla~ions; l\er:lov<l ! of iell().bilsec! pa inVasbcst;)s h"t.lrcs; Rem ova l or h o me ham el's t o the disllbled arK! elcierly; RemOVoll:;lf termites; • The clirr.i natjon of spt'dfr, coodltions de trim e ntal t o public heal :h and saiClY. whICh hiM! been iden lmcd by Programs In spect ors: Rep;lir/lc pl.l ce vr.J l er heal ers; Repair/replace eledrical w ork; R~p.:!ir/fl::vlclte twatmg and ;w-cond,t IO nlng. Install n{'W ins uld lion: • Rep airlt eplace windo ..... stdOClrl; • Install h urricane shuHers; Rc palr/r e plo\ce roofing gullets arrd faSCI a: Repal r/re place plurnll'ng; • Sewer co nnections, ~j1ti c tan l: and drol'mfie ld; Ins tall ney,· smo ke alarms; Rc pair/r eplilce worn. damaged \;:lI chen ol nc bat h flooring; Repl!1r/replace balh fiiduro (non cosm!'tic); Re pa,r/:cplilcc stu CCO; Extellor Pai nt1ng; • Insowll nt'W deo;d bolt loeb: Repa ir wall s; Re;Ja ir roof; and Re pn;rlr eplace kitc hen or bath Cilbinets lnd countt',to ps (ev.dence of detenm,'llon) self mailer p ane! I I I ;l~ --------------~ --,------ I c..t"S~nti(')n R(:5id~rlts ... 1 Who f'\'1 ay Appty I _ , ,-I fYe .creOJ,.~; ilCCC;Jtlng ,'fl(l P(()("e,!".tIl9 I ~plFti:or;sfCl'·j'n:1"l(.ciatE.I:!..-.;6~ fo: It-.!Yf:".\' a.'ld lm.; In:ome ~d:. ;;.x~g~ gu!Cd~'1 e t odrl(>;mi>le I f ~ 1I1~ I fe m ml1X! .md olm!" i.ldJition<l! .:r.t'6 5 yror::;of age o ; ~.TId lVhom~ til(! i a:tr.l ef,(>lJictnnsp-·'U"~la:iin f,i i' d~tty nqu.h.'mrnt5 forutF. rcxyam. :i:i:jifr.lit)' ~uirc:ner'....s If ~1J n ad nxi re;:ni;. 1 :ooJ~ootOr:o:; ftc:al. !O~Dnn shU'.1cr.; in~!OO . ,Fundi.n .g Av ai1abilit-J ~tJlO1" pa.;ntlng. .lII1d oth[!' tu."IaiGn;\! horne I G:olrl! i;J lJ diu;! is m:~de:w~\llbl~ thlOUgll the .. ;Jr.;, ~ mnI.,i.r.~ tt!..'loding .• :lhr: GT)' 01 >r.::u~J I),ohm i Com:nu"ity Rcdl.~pfT3ll 1 t.,g~ i$:'v.G'.l\o h:lSa:rrodj helped nu.-nc-c..:s I City afSouth MUmi eM Tax 11)C1to\Ii'1('11! r;na:ncinq Rcs""l..le'i-T.n: !1I~tT.;':t MBa."l ting :1.yt.'!l:..I(~ .. t !"e d~ from l te i m:r--.ei:l UIf!Gty'!.bxbai;e;tS ~-t.\ !U3!dems tl~C'~gl lhc::c prog<iITlS If'llFlt!;tCl'~"}~ "l ,,., SMe "" Os"', Til e "Sing.l..L--fMrily Pt~9r~-(n" p:o",ce; ~hc k.lkwing ttlf(~ fu .ndi:)g opt-loft',: ~ , , r •• : .... .".. ••• , . ~; C'<\;~f~~' " --"~S",' j 1. Up 10 S2.5 on 'n ga1t.funtling for: I Mir.:H H~ R 6'·;.Ab.jJ6J.~ PJ~a:~ 2 . Up l!l510,OOOin fi'l<ltchi.-::; 5r.ltrr'. flrlcimg f<Jr II Moca-a.:e l -b.rre ?ehit':~?..3:'ot1 ProP::ts: am 3 . :Jp tc.lf1add itiqnzd SS.OOO i n iimi .. u:l m<t".cllng ;rra:m f-.r.>d=ng for M'-'jO:l H o~ I Rclu,"'rift:rti.o:l ?~~ I i I Ti lE ' $\ k .... t! oj ~fl(!lfl ! fund ing nliry' be UlJl i2Ji!!i ;sok ~'o~ :n.lyh<·=mI..!-lred....ith till': 2nJ and !ltd ·lwd:; of m:ltCl,v '9 giant fl:,:ding..Y-tcquitFd I =da n"um l"","n;" I I I I I I I i I I I I I i i I I I I I I Program Bem~f j ts E..Jch .p~1'\ jo;; d~9M<! to prarkit' rClidcrl:hl repair ci.:;!ano:; io-vsoycw ... .,d1o.x.irxxme .hO:r..:>ow'ite!\: Wlo li'ol2;in theSoclJ Mi.1-'1'Ii CRA atSJ:. Th cgO>Ji of t!11? le$dmti.i _;a~btion ;:lIog:;"l1 C. to nlob-It<tin tnt: GOJali!yci thc hOlI~g stocl: in 1he5.\;IQ\A Jo."Qil~"ld ~St1t5ide:lT.~i.n ;X:!d re;<.Vlg cod(!(:n fcrcEIl'lentid.l~ bdud~ tho!.e th:ct prg.ent Ol M /JU\ :!afuly.-.rld wclf ... e · l"clll.l..-'tl CO:'1cun wkh:n theccmmunt.y. Thi::; p'c;r.J:n G :1ot <l tem'Xcii.'lH p-ogF.!m! Program Requ ir e :nents g Appl~"1S mol!: hwca.'l .l.!lnua! ho~id b:an e of S26,5S5 tJ1~whid1 is ~'quiwolenf to iap.;:rQ:;jm;:l tr~h' 75% of !hemali..vJ i lOlf'".ehoid ir.::.cm ~in tnf::Gtf of So.Jth Miam;: A;~.nt!; ITI!J~ Le a.~1tl ... H'"ify ;rr.cmc and~~; ~tio:lSwil l h!': ~~ h 5 MCP.A. Soard ;.ppUl~ U;X;-. !.3'.i!.fuctlon of th e p,W}:.un n !q u;n=,t::,. A;vf..:=Jb: alt! fL'qIUrui tv "'-si:;!n!< S"",w fC!:apl:u-e dCl cwrmr, nnl:J'~;-.;J thad!')(lu ~l(lU\d sd! you: P~lY bL>fcre th~ fM:> )Ull' gr.Y.ll period h .1S OI;;iIl·d, ~d~ iun:.h n9 'l>u<>tbe r(~ :0 the AgCSlC}'U: ;>cis!. cttcr eli 9bk SMCRA. ho\.mhd.::h:. No ~":TI51t of g:i!m 5 IT;q:J«-d ff the.-pmglafll !a::/uiro:rem:; alE' ~\-f.cd by till! a;Jtl!i cmt I i I I I i I I I I I I I I I i I I i I I Bcqu lred Do-cU m ent8ti o n • Co:'i1Pett:rl awli Cilticn .and ds:,b:;:Ji e; w ith ::;ignaum:::: and mte; , ... -sa.. ... D<lde ('Our.:ly l-oii:-.e uf:td 'IIo:OO2l'r1 f,, __ ~ng Cilfren ! ~ ~u€of me propel1 Th.-ee (3) pay ~h!;. for.),!1 housc:-c!d mc;n!:ler., (",cr 18; 5E1f-ernpkrym~t lllrofre :!ol.aterTe:d. \>6ti f xheCurC. E. cr F, Socia! Sewrit~ S1.?'Y!!!rne:tb1 Si.-cJ;n.y !nc....,.:rc CSSO, ar;d ~1b:'Ji:y Be:~ :tnc ?/Oof of l..'f)&l:naJ i:1~n~ dlId 9 -4'pC"Vafu.l o ("~"J~...nrt ~rr: a..-:d 9ft& I ' LETTER OF. INTENT· .' (' :' . 14 LETTER OF INTENT . ! 15 Letter of Intent from Ms. Monique Clark I'm asking for assistance in preplacing the flooring in my home located at 6016 SW 63 St. here in South Miami. I have been in my home a long time, some of the floor tile that was originally place Mo/ post a safety hazard. I need help my income is limited. Thank you in advance for your decision to help me. Ms. Monique Clark 16 PICTURE IDI D1RIVJER~S LICENSE 17 I' .- 18 SOClALSECURITYCARDS . ,' •• ..1'-: • ~ ~-;""" .. " 19 I I I 20 I I I I I I I I I I I I I · ~NCOM!E VERIFi(AT~ON [DOCUMENTS 21 VERJIlFIEDo A¥FIDA VII' OF INCOME 22 & VERIF IED AFF ID AVIT OF INCOME STATE OF FLOR IDA ) 55 COU NTY OF MIAMI -DADE ) BEF ORE ME , the un ders igned authority, personally appeared ___ . ________ _ I ,~ hereby swear and affi rm tha t the income in fo rma tion pro v id ed in Exh ibi t Indica tin g tota l annual earni ngs of ~f1R is true, co mplete and accu r ate and hereby swea r and affirm that total house hold size resi ding at ~._::<'!;ll'tt1li' ~ ___________ _ Miami FI. 33143 is ( Lindividua l, person or people. I understand t h at fal sifica t ion of thi s d o cum ent ma y d isq ualify me f ro m particip at i ng in the SMCRA Re sidenti al Rehab ilit ation Program and m ay resu lt i n re paymen t of SMCRA awarded grant funding. FURTHER THE AFF IA NT SAYETH NA UG HT . AP PLICANT NAME : _______ _ Co-App l icant Name __________ _ Ap pli cant Signature Co-Ap pli ca nt Sign at u re Date : _____________ _ Th e fo rgo in g in strum ent was ac kn owl edged be fore m e t h i s day o f _______ ---' 2017, b y , affi ant who i s e it he r p e r so n ally known to me or who pre sented t o m e i d e nt ificat i on shown below. No tary Public , State of Florida Name : __________ ~ ______ _ Per sona ll y known _____ o r produ ce d Id ent ification _ Ide ntificat i on produ ce d: ________ _ VE RIFIED AF FIDAVIT OF INCOM E 23 VERIFIED AFFIDAVIT OF INCOME STATE OF FlORIDA ) ) SS COUNTY OF MIAMI-DADE ) . BEFORE ME he undersig ed authority, personally appeared ________ ----' , , I, t...,Ic.. ~, {~. ~L'~ ('0 rr~ /. hereby swear and affirm that the income information provided in Exhibit Indicating total ~nnual·earnings of ______ is true, complete and accurate and hereby' swear and affirm that total house hold size residing at ______ .:....-______ _ Miami FI. 33143 is ( ) individuat person or people. I und~rstattd that falsification of this docu'ment may disqualify me from participating in the SM~HA Residential Rehabilitation Program and may result in,'repayment of SMCRA, awarded grant funding. ' Co-Applicant Name _________ _ Co-Applicant Signature Date: ---------------------- The forgoing instrument was acknow.ledged before me this day of ________ -' 2017, by , affiant who iS'either personally known to me or who presented to me identification shown below. Notary Public, State of Florida Name: ----------------- Personally.known ___ or produced Identification _ Identification produced: _____ .,--__ _ My Commission Expires: ______ _ 24 VERIFIED AFFIDAVIT OF INCOME STATE OF FLORIDA· ) . ) SS COUNTY OF MIAMI-DADE ) BEFORE fE, the unders,ned authority, personally appeared I I, ;(/M, {z/.!! CO tb/ , hereby swear and affirm that the income information provided in Exhibit 7 Indicating total annual earnings of _____ is true, complete and accurate and hereby' swear and affirm that total house hold size residing at ______ ~ _______ _ Miami Flo 33143 is ( ) individual, person or p~ople. I und~rstand that faJsification of this document may disqualify me from participating in the SMCRA Residential'Rehabilitation Program and may result in. repayment of SMCRA . awarded grant funding. NAU~H)': . L.(r 'fr 1/ Co-Applicant Name _________ _ Co-Applicant Signature The forgoin.g instrument was acknowledged before me this ___ day of _______ -' 2017, by I affiant who is either personally known to me or who presented to rne identification shown below. Notary Public, State of Florida Name: ________________ __ Personally .known __ ~_or produced Identification _" _ Identification produced:._' _______ _ My Commission Expires: _______ _ 25 VERifiED AFFIDAVIT OF INCOME STATE OF FLORIDA ) . ) 55 COUNTY OF MIAMI-DADE ) BEFOR~ M 7 the undersigned authority, personally appeared ______ ......-_--.:.-__ I, ~{,t'l1((· LU. {; t:vl hereby swear and affir~ that the ;ncome information provided in Exhibit . . Indicating total annual earnings of _____ is true, complete and accurate and hereby' swear and affirm that total house hold siz.e residing at _______ ~ _____ _ .Miami FI. 33143 is ( )individual, person or people. I understand that falsification of this document may disqualify me from participating in the SMCRA Residential -Rehabilitation Program and may result in. repayment of SMCRA awarded grant funding. Co-Applicant Name _--'-_________ _ Co-Applicant Signature Date: ___________________ _ The forgoin.g instrument was acknowledged before me this day of ______ __ 2017, by , affiant who is either personally known to me or who presented to me identification shown below. Notary Public) State of Florida Name: -----------~-- Personally .known _~_or.produced Identification _ Identification produced: ____ . ___ _ My Commission Expires: _______ _ 26 VERIFIED AFFIDAVIT OF NO-INCOME STATE OF FLORIDA ) COUNTY OF MIAMI-DADE : 55 /; ..... / /1 BEFO~;,.I\1I;_Ahe undersj~~Jhuthority, personally appeared 1/ 0"t1"tjV'Sf U& .r , /I//: .' //( ./ I, .. /i,--fj'rft/ /1"'('; C<//t hereby swear and affirm that the income information provided in Exhibit Indicating total annual earnings of _____ is true, complete and accurate and hereby /; /' /'1 -I swear and affirm that total house hold size residing at ~G; ... G::.:.. ... .:=::O:....../....::G.~-",S,-·\A./::=..._..,..f..;:._"' ...;:::S~-:::':YC"L-' __ '.:-,.Y'c'!o........:...e'_. __ Miami FI. 33143 is ( <S ) individual, person or people. I understand that falsification of this document may disqualify me from participating in the SMCRA Residential Rehabilitation Program and may result in repayment of SMCRA awarded grant funding. FURTHER THE AFFIANT SAYETH NAUGHT. / . / . , .. 1' .'"' I ;.';{' Co-Applicant Name _________ _ L. Applicant Signature Co-Applicant Signature Date: J 11'~/l<l I The forgoing instrument was acknowledged before me this I:) day of .~~./\\ ( I 2018, by , affiant who is either personally known to me or who presented to me identification shown below. Notary Public, State of Florida Name: ______________ _ Personally known ___ or produced Identification _ Identification produced: _______ _ My Commission Expires: ______ _ 27 Certificate of Birth 28 .. ; !. of VITAL STA ". , I :' '_" 'pro II r:: 't-:J '~. , .. ' CERTIFICATION OF BIRTH STATE FlLE . 'UM BER: DAT E Fi LE D: March 27, ]978 SEX: " " COUN TY OF BTlZTI-I: " -~~;.h " ' \'" ~ , ;.:: ., '. ~:.,.' 'i ~ ;. . .,./ • .', . ~ \' ,-,t, .:. . :0' :.' JVi0N1QUE YVETTE ' CLARK March 2 7,.19,78 ,', FEMALE " lVUAM1-DADE COUNT Y YVONNE E CLARK THIS SPAC~ INTENTIONALLY LEFT BLANK r~'.{.;. .. ~~~'-: .. ~,-' 't;~, .>:~ ,I) , ,iI ~ 'oI~i~~? Apr il 4,20 16 " ,; ." ~'. ' I Sta te Re g is trar * 3 1 9 5 3 16 9 * -. Proof of . Income 30 ARE THERE ANY INCOME RESTRICTIONS? YES, Elig ible und er this program shall be limited to those w ho are t h ose who are n o hig h er t han 80% of t h e median income of the city of South Miami as es tabli she d by the US HUD (Guidelines) Income Limits Foll owing are the in co me limi ts by fami ly size and admission in co me ta rge l ing req uir ement s ror th e Publi c '-lou sing , Sectio n 8, and Modera te Re habili i r prog rams: . " The area median in co me for Miami ·Dade County is: $52,30 0 . IS ANY HOME THE REDEVELOPMENT AREA ElIG I BLE REGARDLESS OF MARKET VALUE YES. CAN A HOME QUALIFY FOR REHABIITION GRANT UND ER THIS PROGRA M REGARDLESS OF MORTAGE DEBT? YES. A ll homes i n the redeve l opm en t ar ea eligi bl e for fun d ing under t his p rogr am this program even if mort ga ge dept. exceeds estima tes market s va lu e. 31 CLARK, MCNIQUE Employee Number Department Number Advice Number Period Begin Date Period End Date Advice Date EARNINGS DESCRIPTION Regular AFSHiCI UnplanPL AFSSwP AFSHiCIE PLCntOt PlanndPL EariyOPL Uniform OnCalVVH LatelnPL Total Earnings SUMMARY Total Gross Earnings Total Pre-Tax Deductions Total FIT Taxable Total Taxes Total After-Tax Deductions Total Net Pay i. __ . ( . 06/1712018 06/30/2018 07/0612018 HOURS RATE 56.00 18.569 16.00 18.569 8.00 18.569 16.00 1.000 Federal Mantal Status Federal Exemptions Additional Withholding CURRENT $1,03987 $297.10 $148.55 $60.00 $16 00 $1,561.52 CURRENT $1.561.52 $60.84 $1,50068 $274.06 $2644 $1200.18 510gle 00000 0.00 YTD $13,64824 $5,278.19 $29710 $84000 $28425 $1,039.85 $29710 $227.47 $200.00 $10750 $9.28 $22,228.98 YTD $22,228.98 $856.79 $21,372.19 $4.01130 $37522 $16.985.67 TAXES AND DEDUCTIONS PRE-TAX DEDUCTIONS LTD PHTEE STD Total Pre-Tax Deductions TAXES Fica FIT CURRENT YTD $458 S64.i2 $4685 5660.93 $941 $13174 $60.84 $856.79 CURRENT YTD $9594 $1,366.05 $155.68 $2,32577 ACCOUNT DISTRIBUTION ACCOUNT # AMOUNT Medicare $22 44 $31948 personal Total Distributions PAID ANNUAL LEAVE AVAILABLE Ext III Pl Jackson M=I HEAL Til SVS1'E.\i 1611 NW. ;Z' AvemJe Ml8ll'u. FL 33136 T $1.200.18 Total Taxes AFTER·TAX DEDUCTIONS Optufe $1,200.18 UnvlfR1 Sodexo BALANCE 98.05 13811 Total After-Tax Deductions Wells Fargo Bank, N.A. San Francisco, CA $274.06 $4.011.30 CURRENT YTD $3.90 $44.87 $1652 522080 $6.02 5109.55 $26.44 5375.22 11·24/1210 PA Y I/O/.!J I/O/.!J I/O/.!J I/O/.!J I/O/.!J 1/0/ iJ j/O / iJ j/O/ iJ TO THE ORDER OF MONIQUE CLARK 6016 SW 63 STREET MIAMI. FL 33143 DIRECT DEPOSIT ADVICE NON-NEGOTIABLE 32 CLARK. MONIQVE Employee Number Department Number Advice Number Period Begin Date Period End Date Advice Date EARNINGS DESCRIPTION Regular AFSHICI AFSSwP AFSHiCIE PLCntO! PJar.ndPL EarfyOPL Uniform UnplanPL OnCalWH LatelnPL Total Earnings SUMMARY Total Gross Earnings Total Pre-Tax Deductions Total FIT Taxable Total Taxes Total After-Tax Deductions Total Net Pay 06/03/2018 06/16/2018 06/22/2018 HOURS RATE 6400 18569 16.00 18.569 16.00 1.000 Foderal Marital Status Federal Exemptions Additional Withholding CURRENT $i,18842 $297.10 S6000 $16.00 $1,561.52 CURRENT $1.561.52 $60 84 $1,50068 $274.07 52680 $1.199.81 Single OOOCO 000 YTD $:2,608.37 $4.98109 $78000 $268.25 $i,03985 $29710 $227.47 $200.00 $14855 $107.50 $9.28 $20,667.46 YTD $20.667.46 $79595 $i9.87151 $3,737.24 $34878 S15.78549 Jackson IIEAL:-!I sysr[; ... TAXESANDDEDUCT~NS PRE-TAX DEDUCTIONS LTD ?HTEE 570 Total Pre·Tax Deductions TAXES Fica FIT CURRENT YTD 5458 $5954 $4685 $614.06 $9.4i $122.33 $60.84 5795.95 CURRENT YTD $9595 51.27011 5155.68 52.170.09 ACCOUNT DISTRIBUTION ACCOUNT # AMOUNT Meolcare $2244 $29704 personal Total Distributions PAID ANNUAL LEAVE AVAILABLE Ex1 III PL Jackson IIFA1:T1I !>Y"'-E.\l 16~' NW 1l'" Avenue Mia:n,. FL 33'35 I Total Taxes $1.199.81 AFTER-TAX DEDUCTIONS OptLife 51,199.81 UnvLfR1 Sodexo BALANCE 9620 137.19 Total After-Tax Deductions Wells Fargo Bank, N.A. San Francisco, CA 5274.07 53,737.24 CURRENT YTD $3.90 $40.97 $16.52 $20428 $6.38 $10353 $26.80 S348.78 11-24/1210 Date 6/22/2018 '·:.~~~vitt.~:;.>.~ PAY j/O / LJ 1/0/ LJ 1/0/ LJ 1/0/ LJ 1/0/ LJ 1/0/ f} 1/0/ f} 1/0/ LJ $ "+""*1,199.81 lOTHE ORDER OF MONIQUE CLARK 6016 SW 63 STREET MIAMI, FL 33143 DIRECT DEPOSIT ADVICE NON-NEGOTIABLE 33 Estimates 34 Estimate # 1 Eagle Wood Floor, Inc. 35 .. '.' .... , .......... ~ ............... -... ~-........... _,. ~ ... ,~-_ ... _----... .. .-... _". --" .... _ ...... , .. _ .......... , I j ; ..... -.-!-.-.... -._.-..,_. ... .. -_..... . .. : I • • • I • EAGLEWOOD FLOOR, INC. ;43';:;-16;~;"" ... -.-.. -..•. ---. -...... --_ .....•. j-'" ._ .. . -M-la-m-I,-FL 3;1~-;-"-_. ...-. _e· '1-·-.; .............. i-'--"-." .... ..1 ••. __ ._. '-.-' -.-.... . ....•..• . .• : PROPOSED CONTRACT . --~ :·~-L·.~.~. ·-·~·.·-·~-~~ ... ~L-~~·-~~~-~l··~·-~~~~~J .._._ .. , ........ (-_... ..-.~ ._._ .. ---f---.--. --; .... -.- r------.------... -............ . I CELL: 786-246·7292 . I f---... -.. --... ---~ .... -.. ----....... ;--_ .... -_···--.. 1·· ... -.-~ .. !'~~!!2'.:~~~~.~., .... __ ...... _n. __ '.. . .... J ! SUBMITTED TO: Monique iADDRESS: 6016 sw 63 st miami n 33143 Installation of wood floors Intallation of wood floors .Include all materials.sound proof and laminate wood floors 2 'nstalltlon of molding .Include moldings 3 4 PAYMENT TERMS I BEFORE WORK START 50% L S 3.COO.00 UPON TOTAL COMPLETION 50% IS' 3,OOO.CO DURATION WOOD DELIVERY LEAD TIME WOOD ACCLIMATION BEFORE INSTALLATION SUB FLOOR INSTAL1.ATlON WOOD FLOOR INSTALLATION WOOD ACCLIMATION BEFORE SANDING SANDING AND FINISHING FLOORfCARPET REMOVAL CONCRETE SLAB LEVELING eSTIMATED TOTAL TIME UNTT 1100 X 55 DAYS .. _ .. _ .. ___ ........ SP.EC.1f{9~TIONS. DATE: 3/26/18 E-mail . MOBILE: 305-479-4464 TEL; PAYMENTS SUBTOTAL $ Total $ OBSERVATIONS Wood delivClry 4 or 5 days bllforo ordors. 40 5.500.001 500.00 6000.00 6000.00 __ !2Il:IM. .. __ ... _ .................. _ .. _._._._._._ .. _ .... _ __ ..... __ .... ___ ............ ____ .. ___ ...... _ ...... ____ . __ . __ ._ .... _ ........ __ .... _ ..... __ ........ _ .. AlC SYSTEM MUST BE WORKING PItOPERLY DURING THE ACCLIMATION PERIODS AND AFTERWARDS TO ENSURE A PROPER HUMIDITY LEVEL -T"ifECUSTOM'eRWILlSE'R"ESPONSiBLEFoiiTOUCHINGilpWAllS'ANDOOORSiFNEEDEDAfTERINS'rALU'riC)if"·----.-.. -. -.. ----.-•. -.. ---..•.•.. --..... -.. _.-.• THEAAEASMUSTBSFREEEO"Fi=URNiiuRE;-OEOiiiii"ANDOF AN~'-MAiERiALsTEFTiiyo'iHERCONTRACTORS" ---•• ----.. ---.-•. , --. -.••. - ---FiNAL PAYMENiUP-ON THECOMPLETIONOj:-THE JOBCONlRACTEi> MU'Sr"NOTBESUaJECTeOTOTHE ClOSINGOFp·ERMITS--·-----· ..•.• -._ ..• --_e' •. -ACCEPTEo·CO"NTAACTS·MUST·Be SIGNED·AND ACCOMPANIED eVA 50%' D'OWNPAYMeNT --.. -"---'--'.' '--'----.-....... --....... _-. = 1101220 ELEC'iR!.CIT'i M~S.!!i_~~~Dll.Y·AVAILA~ "-==':'::.~':::==~-='.'=":=:-":'-==~:.==::=-:~.=--=--==':~-=--:'-.:~~.~.~ :'.~ .~.~: ... :~_ .. : ----_._--_ .... _ .. _._--_.-_ ... __ ...... --' ... -.---........ _. __ ... _ .... _--_.-._-----_._._. -------_ .•. _-----.--.-. ~BBANTY __ . _._ .. _ ...•.. _ .... ___ ......... _ .... _ ... __ ......... .. . _._ .... _ .. __ . __ .. ____ . __ .. ___ . __ .. _ ... _____ .. _ ... __ ... _ ..... _._ ........... _ ........ . OUR INSTALLATIONS ARE DONE PROFESSIONAlLY ACCORDING TO THE STANDARDS ESTABLISHED BY THE NAFTA AND THE NORMA -.-SUPREMEWOOOFLOOR wi\R-RANrYDOEsNo"1"COVERitioENTATAT.oNS, ·Si:AACtiES:stAiNORDAMAGECAuSelrBYt·jEGliGENCE:·FiRE~LOODiNG.. - --EXcessiVE tiOiSTuRiI"DuejoAIRcONDWIONtR-MAL.FU·NCflo"NiNG. -ERosiot( PEBBLEs. SA-NOAN·OOlliER ABRAsiVEElEMENTS,PETS-:!NsECTS,·-'···· -. __ • -. .•. -.. 1---: SPIK~DHE.!-~stiOES')!A!.U:,!~(C!iS:A~l~~~~~i.0!f.~Aiii~!~~,_i".~ROP-ER ~~NTE~~~."\VEt~~~f~":~·:"--==·~~.~·-_:_~.=--::===·~~-:::~= :_.~. ~ -~. ~ ..... ~~ ..... --ArCOFfHE SPeCtFIcATIONSANDCONDiiIONS'AREHEREACCEPTEO UNLfss'sT'Affi'oTHERWisE"mrHEABOVeDESCRrPTic5Ns ._ .. ----..• ---.•. --.. -.... -..... -. -' .. --.. --_ ... _ ... _ .. _.-.... -...... -_ .... _-_. . " .... . ~_~.c.Fr:IAN.9t._ ... _ .. _ .......... _ . _____ .. __ . __ ........ . 1_ THE ABOVE PRICES. SPECIFICATIONS AND CONDITIONS ARE HEREBY ACCEPTED. I. THE UNDERSIGNED.IlEREBY ACCEPT AND AUTIIORIZE SUPREME WOOD FLOOR TO COMPLETE TIlE WORK ___ ._ .•. ___ . ___ .... _ ._ ._ .. ___ ~!'.E~!'tt;Q.~9~ .. ~~.Q.L~_U.~~!I;!l ~!!~.EE .1~ MAKE ~~~D~C?~.I!~_'!~I:' WOI~)[~ ~~OOR ~~I!I!:...~ ~~~_ .• _. __ ._ .. _. __ .. _ .. _. . __ ._ . ,-I UNDERSTAND THAT BY SIGNING BtLOW I HAVE A:CEPTED TIllS PROPOSAL WIIIC" WILL NOW HAVE THE POWER OF A CONTRACT BINO:'«> BOTH PARTIES TO ITS TERMS AND CONDITIONS. THE _ NO FULFIllMENr OF TIlE AGREED TtRMS ANO CONDITIONS BY TIlE CLIENT WU RESULT IN THE AIJTOMATIC TRANSFER OF YOUR ACCOUNT TO OUR QUICK RECOVERY AGENCY. ~~i~~~.~~~~-·-· .. .-.. ~ '~r~-:':-~~~:-~~~~:f~;~~~ii~~~:~~~~~::~~~~:~f~~~~ :::_-1 == =. :~ ~."~:~~:': ..... ~ ....... ,_." ,"_.~ '_'. j',:': ... ~:":_.:~~ ::~.~~~:~~ .. : ... :.=:_:·.~.t·~:.::i·:.~.=:::J:.===] t I 1 36 Estimate # 2 A. L.J Su perior Home Improvements 37 - A.LJ. Superior lfome Improvements INVOICE p.o. BOX 971308 • MIAMI. FlORIDA 33197-1308 630 " ,CELL: 305-9Q5..7083 • OFFICE: 3()5..254-2080 • FAX: 305-254-9888 INVOICESUBMIfTED TO: WORK 10 BE. , .f~ NAME JV(I> k..v.: v€' rlM(~ .. START DATE JOB lOCATION ADDRESS t;;ol0 '57P -~ '3 s1-. ' ADDRESS S~t;" fa &1/1 CflYisooFmp ~ ~ tIU,'. _g_-?JrJ {'f3 CIlYJSTATFJZiP COMPIEnOlf DATE PHONE ~ 05· Lf79· Y'f G? L1 PHONE ~&,...'" we ffEREBY PROJ'OSETD PERfORM THE lABOR NECESSARY FOR lIfE COfiIPLEIIDN OF: TOTAL :::r. .J. J --'-AJ~t v-. -;jrt:.. 41'\.0.. • .1 "i'~ ~ d'f. t!hf- ~(~ .... Ilci ~1oot:1,U -t>A I ~;G h.ov~ '. ~lu~ Y~IJADJ~ 1ACA..~( , f V\..' *-i-(I!tJt ~ c!)-R-b4s'()'" ~I\-Vd~· , (,tnTf) ~, &~. ~ to 5.cJO DJe!Y t¥d. ~,~ v r " '" /' , i SubTotal t; I t,?Vt) Tax Total SJ~ ," Deposit ~Jfhi) BalaoceDue a-,Pl1t:J .. , All ma1aoiIIls aua~ and the above work to be perforrnsd In 8CCOIdance wilhthe drawings and/or specifications subm!lledfor abo~ comp! i substantial workmanlike manner for the sum of: ' '--'Dollars ($ i ~ ,l/l)?;J , ) with payments to be made as follows: ~ is requfred 24 Hours before job starts and 1he balance is due 24 Hours before job ends. AGREEMENT ,The abc::Mprices. specification and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Pa)'JTI8nts will' be made ~ned above. /:I, --L Date: ~~ Sig&bgejJ I/vv--~ t"I'A. L Date: ~Lferl/~ ~_ds_~re "-} i 38 Estimate # 3 All Florida Construction 39 • ' •• J. ", ~ .. . , :.' c ' ' .. FLeFlIDA: CCNSTRUCTIQNCC. . .• • v' . 7380 So W.l1"·P\.a SaiIo .l907 · . om.. flarida ml4 . ,;, ... 'pR()PQ.~:., 'coNTRAcT . . ,. "~Divi&,o~' ., , .. " 40 " .; , Estimate # 4 EM PI RE TODAY 41 Page 1 of 15 EM ~~RETODAY rt'--' 800·588·2300 Consent to E-Delivery of Documents and Installation Updates: Check boxes below Contract Delivery ~Accept E·Delivery: I agree that you can provide me with my copies of the contract that I sign on this device, and all accompanying paperwork and subsequent documents related to this contract, by email at the email address I have provided and verified below. I represent that I have Internet access to that email address, and the capability to read, print, and store emails and attached PDF documents, including the equipment and software necessary. In addition to electronic delivery, if I want to receive paper copies of my signed contract and accompanying paperwork at my home, I can request such copies by sending you an email to contractrequests@empiretoday.com or by calling you at 1·866-588-2325. My contract and a/l accompanying paperwork will be sent via email to: Primary Email Address Secondary Email Address moniquefavor@yahoo.com DDecline E·Delivery: I do not want electronic delivery of my documents. Please send me a paper copy of the contract that I sign on this device, accompanying paperwork and subsequent documents by overnight delivery service to: [Select one} Updates on Mv Installation o Contact me with installation updates at (305) 4794464. Message and data rates may apply. I consent to Terms of Use and PrivacY Policv. Monique Clark Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 42 Page 2 of 15 Product Specifications Please Read EM D'tRETODAY r f 800·588·2300 CGC1509675 tt is agreed and understood by and between the parties that this Product Specification, along with all of the other pages of this agreement that I sign (collectively, the "Agreement") constitutes the entire understanding between the parties, and there are no written or spoken understandings changing or modifying any of the terms of this Product Specification. I hereby acknowledge that I have read and accept this Product Specification. ,-~ ... --~ ................ _'. 0,. "._, .,,", •• . . ! Laminate Room Name Collection Series Style Living Room Laminate Residence Ebony Option Name Value Take Up Take Up Hardwood Nailed or Glue Down Installation Method Floating Installation Install Diagonal No Underlayment Quiet Walk (Upgrade) Moving Heavy nems Furniture Laminate -Wall Base White Dining Room Laminate Residence Ebony Option Name Value Take Up Take Up Hardwood Nailed or Glue Down Installation Method Floating Installation Install Diagonal No Underlayment Quiet Walk (Upgrade) Moving Heavy nems Furniture Laminate -Wall Base White Kitchen Laminate Residence Ebony Option Name Value Take Up Take Up Hardwood Nailed or Glue Down Installation Method Floating Installation Install Diagonal No Underlayment Quiet Walk (Upgrade) MOving Heavy ttems Furniture MOving Heavy ttems Appliances-Refrigerator,Stove,Portable DIshwasher" Hallway Laminate Residence Ebony Option Name Value Take Up Take Up Hardwood Nailed or Glue Down Installation Method Floating Installation Install Diagonal No Underlayment Quiet Walk (Upgrade) Laminate -Wall Base White Laundry Room Laminate Residence Ebony Option Name Value Take Up Take Up Hardwood Nailed or Glue Down Installation Method Floating Installation Install Diagonal No Underlayment Quiet Walk (Upgrade) Moving Heavy ttems Appliances-Refrigerator,Stove,Portable Dishwasher- Bathroom Laminate Residence Ebony Option Name Value Take Up Take Up Hardwood Nailed or Glue Down Installation Method Floating Installation Install Diagonal No Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 43 Page 3 of 15 i Underlayment i Other Miscellaneous I Charges ! Laminate -Wall Base i I Bedroom , Option Name I Take Up ! Installation Method i Install Diagonal I Underlayment ! Moving Heavy ~ems i Laminate -Wall Base / ! Closet ; Option Name I Take Up I Installation Method Install Diagonal I Underlayment i Bedroom 2 ! Option Name Take Up Installation Method Install Diagonal Underlayme nt Moving Heavy Kerns Laminate -Wall Base i Closet2 I Option Name I Take Up I Installation Method ! Install Diagonal I ,' Underlayment Bedroom 3 I ~::~oCpName 'I' Installation Method Install Diagonal I Underlayment I MOving Heavy ttems I Laminate -Wall Base I Closet 3 Option Name , Take Up Installation Method Install Diagonal Underlayment Quiet Walk (Upgrade) Toilet -remove I reinstall! both White Laminate Value Residence Take Up Hardwood Nailed or Glue Down Floating Installation No Quiet Walk (Upgrade) Furniture White Laminate Value Residence Take Up Hardwood Nailed or Glue Down Floating Installation No Quiet Walk (Upgrade) Laminate Value Residence Take Up Hardwood Nailed or Glue Down Floating Installation No Quiet Walk (Upgrade) Furniture White Laminate Value Residence Take Up Hardwood Nailed or Glue Down Floating Installation No Quiet Walk (Upgrade) Laminate Value Residence Take Up Hardwood Nailed or Glue Down Floating Installation No Quiet Walk (Upgrade) Fumiture White Laminate Value Residence Take Up Hardwood Nailed or Glue Down Floating Installation No Quiet Walk (Upgrade) Ebony Ebony Ebony Ebony Ebony Ebony Activity Id: 1-3354535048 Empire/Residential/Miami EMP~RETODAY :r 800·588·2300 44 8/6/2018 Page 4 of 15 EM MRETODAY rr 800·588·2300 ~ By signing below, I confirm that I have reviewed and agree that the Product Specifications above are complete, accurate and correct based on my selections and that I am not relying on any oral or written modifications or promises relative to these Product Specifications. Monique Clark Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 45 Page 5 of 15 Contract Payment Details Buyer 1 Monique Cia rk Billing Address 6016 S.w. 63rd Street Miami FL 33143 Buyer 2 Installation Address 6016 S.w. 63rd Street Miami FL 33143 EMP~RETODAY r 800588·2300 CGC1509675 Contract Amount $8.500.00 I~~~pi~~~ ... ::~:~~:=~" ~':".='~~'='~ .. ~~'~~=~'::~"" .. ='.::"~ .. : .. =:~:::~"~: ...... ~_.... .._.. . .... ::~' .... ~~~~'~:" .. ::'~"''': .. ~~~~ ... ~:~~''''~ .. ~~:~~ .... '~~'-"":'.'~~.:~.~~"~=~=~~~' .. ~ .. ~" ... :~:.::' .~:"~ .. ~~~~~~~~~~=.~': .... ~'~~.~~~':.::~§.~§. Contract Total $8.500.00 .............. ._ .. _ ... _ .............................................. m •.............................................................................................. "'..... ......... . ..... • .................... . ........................................................... ., ............. -............. " ................... -............. • .... -" ........... $· .. o~6o· .~~p.~~.~!.~.~.~!.1t. .............. _ ........ _.............................................. ........... .. ........................ .. ................................................................................................................................................................................................................................ . . I?~P~~.~~ .. ~~!~.C?.~...................... .... ...... .... ................... ....... . ............ ................... ..... ............ ....... ...................... .. .. Amount Financed ........... ........... ....... ....... . ................ _ ...................................................................... · .. ·· .... · .. ·$()':O·O ~~~~~~!~~~~~.: .. :::::~~.~ ... ~.: .......... :: .... : .... :~.~~ .. : .. : .. ~ ..... :~ .. : .. : ... :.:.: .... : .... ~: .... ::: ..... ~ .... : ...... :.: .. =:: .... : ... ~ ...... "~:.:.: ... ::" ... ::~::.-. .. :~:~~~~~~ .. ~.:::.~:~~~~ .. ~.: ... : .. : .... ~.:.~:=~~:~.~~ ... ~:.~ ~.~.: ....... ~~~:: .. :::~:~~ .... : .. :.: ....... _: .. ~ .. ~ .... ~ ..... ~ ..... =~~~§~~§.~§9.: .~~!irn...!ted D~~.~~.IY_~~~_ ... __ .. _._.......... ... ..... ........ _ ........................... _. .. ..... " ........ .. .... ., ........................ """._ .. __ ............ _..... . .......... __ .... ____ ........................ _!'J('~ Estimated Start Date 8131/2018 ...... ___ •• _ ... _ .... __ ... _ .............. _ ...... _., ....................... _ •• _ ................. , ....... _.'.' ........... _ ...... _ ................... '_ •• _ ....... _ ••••• _ ....... _._ .......... _ ......... __ • ___ ._. ___ ...... 0-••• _ .. _ .............. _ •• _ •• '"'' ..... _ .... _ .. _ ••••••• -._._ ... _~. --0 ... _ .................. _ .... _ .·_M ........ --.. __ ··· .. ·· .. ·_· _., .... _ ..• _. Price and Payment Terms All financing subject to third party lender and credit approval. Empire Today. LLC is neither a lender or broker. By signing below, I confirm that I have reviewed and agree that the contract amount and payment details. including deposit amount and balance due, are full, accurate and correct based on my selections included on the prior Product Specification screen, and that I am not relying on any oral or written modifications or promises relative to these contract payment details. I agree and understand that if J finance the work by Empire or a third party. my separately provided financing documents win include the number of monthly payments and the amount of each payment, including any finance charge. It is agreed and understood by and between the parties listed below, that this Agreement, above and below, and any Specification Sheet(s), Installation Checklist, or addendum(s), constitutes the entire understanding between the parties, and there are no written or spoken understandings changing or modifying any of the terms of this Agreement. This Agreement may not be changed or its terms modified or varied in any way unless such changes are in writing and signed by both the Buyer(s) and Empire. An Empire yard sign may be placed on your front lawn for the duration of the installation. ~By checking here, I further agree that if at, or before, the time of installation, Empire determines that my sub floor needs to be repaired or replaced, either (1) I will be responsible for the repair or replacement and all charges related thereto, or (2) if able, Empire will repair or replace my sub floor and I agree to pay Empire an additional amount for this work. YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORM(S) FOR AN EXPLANATION OF THIS RIGHT TO CANCEL Monique Clark Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 46 Page 6 of 15 Notice of Right To Cancel Please Read NOTICE OF CANCELLATION Date of Transaction: 08/06/2018 EM ~RETODAY ri"' 800·588·2300 You may cancel this transaction, without any penalty or obligation, within three (3) business days from the above date. If you cancel, any property traded in, any payments made by you under the Contract or Sale, and any negotiable instrument executed by you will be returned within 10 days following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the Seller at your residence, in substantially as good condition as when received, any goods delivered to you under this Contract or Sale; or you may, if you wish, comply with the instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk. If you do make the goods available to the Seller and the Seller does not pick them up within 20 days of the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Seller, or if you agree to return the goods to the Seller and fail to do so, then you remain liable for perfonnance of all obligations under the Contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice or send a telegram to: Empire Today, LLC Attn: Legal Departrnent 333 Northwest Ave Northlake, IL 60164 NOT LATER THAN MIDNIGHT OF DATE: For E-Delivery: 08/09/2018 For Mail Delivery: 08/13/2018 YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORM(S) FOR AN EXPLANATION OF THIS RIGHT TO CANCEL. I HEREBY CANCEL THIS TRANSACTION. Buyer's Name (Please Print) Buyer's Signature Date (Please Print) Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 47 Page 7 of 15 Notice of Right To Cancel Please Read NOTICE OF CANCELLATION Date of Transaction: 08/06/2018 EM naRETODAY rr 800·588·2300 You may cancel this transaction, without any penalty or obligation, within three (3) business days from the above date. If you cancel, any property traded in, any payments made by you under the Contract or Sale, and any negotiable in~trument executed by you will be returned within 10 days following receipt by the Seller of your cancellation notice, and any security interest arising out of the transaction will be canceled. If you cancel, you must make available to the Seller at your residence, in substantially as good condition as when received, any goods delivered to you under this Contract or Sale; or you may, if you wish, comply with the instructions of the Seller regarding the return shipment of the goods at the Seller's expense and risk. If you do make the goods available to the Seller and the Seller. does not pick them up within 20 days of the date of your Notice of Cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the Seller, or if you agree to return the goods to the Seller and fail to do so, then you remain liable for performance of all obligations under the Contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice or send a telegram to: Empire Today, LLC Attn: Legal Department 333 No"rthwest Ave Northlake, IL 60164 NOT LATER THAN MIDNIGHT OF DATE: For E .. Delivery: 08/09/2018 . For Mail Delivery: 08/13/2018 YOU, THE BUYER(S), MAY CANCEL THIS TRANSACTION AT ANYTIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ACCOMPANYING NOTICE OF CANCELLATION FORM(S) FOR AN EXPLANATION OF THIS RIGHT TO CANCEL. I HEREBY CANCEL THIS TRANSACTION. Buyer's Name (Please Print) Buyer's Signature Date (Please Print) Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 48 Page 9 of 15 EM DttRETODAY rr 800·588·2300 I nstallation Checklist We hope you have a great flooring installation experience. To help deliver this, we want to confirm some details: • Installation Date and Time -We must confirm scheduling details with you. We need t"'010 good phone numbers for you. If we are unable to reach you, contact the Customer Service Team at 800-588-2300®. Installations generally occur between 8 a.m. and 6 p.m. We will provide an estimated window for arrival the morning of your installation. • Responsible Adult -An authorized adult must be on-site for the duration of installation and to provide payment. Empire accepts cash, major credit cards. money orders, certified checks, and personal checks subject to approval. At the start, the adult must verify product, color(s) and installation area(s), and when complete, walk through the installed area(s) and sign a Certificate of Completion (for financed purchases, the customer who signed the contract must sign the Certificate of Completion). • Installation Requirements -To ensure proper installation: o Before installation, you are responsible for disassembling and/or moving beds and built-in furniture; draining waterbeds; disconnecting electronlcs, appliances (including gas lines) and plumbing (and reconnecting when complete); removing from the installation and access areas, and storing in a safe location: furniture (unless you purchased standard furniture moving), objects (clothes, toys, shoes), knick-knacks, breakables, valuables, pictures, wall hangings, grandfather clocks, pool tables, filled aquariums, and pianos. Remove draperies and disconnect window alarms and components for window treatment Installations. o Keep pets in a safe location. o You may need to touch up, paint or stain baseboards or walls (installers will do their best to be careful, but nicks, scratches and scoring of your baseboards and walls may occur). Please remove moldings prior to the installation and safely store them if you plan to re-use them. While installers will attempt to minimize and clean-up dust, you may wish to consider covering vents or other areas. o You are responsible to cut or adjust doors following installation if necessary. Installers will re-hang doors if possible. o Following installation, tile instal/ation and grouting must remain free from foot traffic for 12 hours. o Maintain a temperature of 65° -85° 48 hours prior to installation, and appropriately use a humidifierl dehumidifier. o Tell us if you have hidden low voltage wires, plumbing, radiant heat, or other factors that may be affected by the installation. • Subfloor -If, at or before the time of installation, it is suspected or determined that asbestos is present, installers will stop the installation until you have tested for asbestos, which must be removed by a licensed abatement company and a clean air certificate received before installation can continue. While installers will moisture-test concrete slabs before installing hard surface products. if testing requires corrective measures before the installation can proceed, this will be necessary at your expense. If the subfJoor must be repaired or replaced, Empire may so do if you agree to pay for additional subfloor repair or replacement. Please contact our Customer Service Team at 800·588·2300 if you have any additional questions about your purchase. 01 represent that I have read, understand. and agree to the foregoing Installation Checklist, and confirm that I am not relying on any oral or written modifications or promises relative to the Installation Checklist. By signing my name, I confinn that I have reviewed, fully understand and agree to the details in the Installation Checklist above. MoniQue Clark Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 49 Page 10 o f 15 Terms & Conditions P lease Re ad 13:<0 SW 32 nd Way, Deertie ld Beach, FL, 33442 , 800-588 -2300 , emprre lodaY .com CGC1509675 EMP~RETODAY i ' 800·588 230 0 lO r', "my," and "me" me an each person who signs tilis Agreement as a buyer. "Emp ire" means Empire Today , LLC , the contractor. "We" an d "us " mean both the buyer , or buyers if more than one, and Empi re . ACCORDING TO FLORIDA'S CONSTRUCTION LIE N LAW (SECTIONS 713,001-713.37, FLORIDA STATUTES), THOSE WHO WORK ON YOUR PROPERTY OR PROVIDE MATER IALS AND S ERVI CES AND ARE NOT PAID IN FULL HAVE A RIGHT TO ENFORCE THEIR CLAIM FOR PAYMENT AGAINS T YO UR PROPERTY. THIS C LAIM IS KNOWN AS A CONSTRUCTION LIEN. IF YO UR CONTRACTOR OR A SUBCONTRACTOR FA ILS TO PAY SUBCONTRACTORS , SUB-SUBCONTRACTORS, OR MATERIAL SUPPLIERS, THOSE PEOPLE WHO AR E OWED MONEY MAY LOOK TO YOUR PROPERTY FOR PAYMENT, EVEN IF YOU HAVE AJLREADY PAID YOUR CONTRACTOR IN FULL. IF YO U FA IL TO PAY YO UR CONTRACTOR, YOUR CONTRACTOR MAY ALSO HAVE A LIEN ON YO UR PROPERTY. T HIS MEANS IF A LIEN IS FILED YOUR PROPERTY COULD BE SOLD AGAINST YOUR WILL TO PAY FOR LAJBOR , MATERIALS , OR OTHER SERVICES THAT YO UR CONTRACTOR OR A SUBCONTRACTOR MAY HAVE FAILED TO PAY. TO PROTECT YO URS ELF, YOU SHOULD STIPU LATE IN THIS CONTRACT THAT BEFORE ANY PAYMENT IS MADE , YO UR CONTRACTOR IS REQUIRED TO PROVIDE YO U WITH A WRITIEN RELEASE OF LIEN FROM ANY PERSON OR COMPANY THAT HAS PROVIDED TO YOU A "NOTICE TO OWNER." FLORIDA'S CONSTRUCTION LIEN LAW IS COMPLEX, AND IT IS RECOMMENDED THAT YOU CONSULT AN ATIORNEY. ANY CLAIMS FOR CONSTRUCTION DEFECTS ARE SUBJ ECT TO THE NOTICE AN D CURE PROVISIONS OF CHAPTER 558 , FLORIDA STATUTES. FLORIDA HOMEOWNERS' CONSTRUCTION REC OVE RY FUND : PAYM ENT MAY BE AVAILABLE FROM THE FLORIDA HOMEOWNERS' CONSTRUCTION RECOVERY FUND IF YO U LOSE MONEY ON A PROJECT PERFORMED UNDER CONTRACT, WHERE THE LOSS RESULTS FRO M SPECIFIED VIOLATIONS OF FLORIDA LAW BY A LICENSED CONTRACTOR . FOR INFORMATION ABOUT THE RECOVERY FUND AND FILING A CLAIM, CON TACT THE FLORIDA CONS TRUCTION INDUSTR Y LICENSING BOARD AT T HE FOL L OWING TELEPHONE NUMBER AND ADDRESS : 1940 North Mon r oe Street, Tallahassee , FL 32399-1 039/Phone : 85 0.487 .1395 Bu ye r's Right To Ca nc e l: This IS a ho me so liC ita tion sale , and if you do not want the goo ds or services, you may ca nce l thi s agreement by provid ing writt en not ice to the se ll er in perso n. by telegram , or by ma il. This no tice must indicate that you do not want the goods or se rvi ces an d must be delivered or pos tma rke d be fore midnight of the Ihird business day a Her you sign Ihis ag reement. If yo u cance l this agreement , th e se ll er may nol keep all or p ari of any cash d own payme nt Empire's Promises: Empi re prom ises to periorm all Vlork in a professiona l man ne r and within ind ust ry standards . Emp ire will re move and transpo rt away fro m my property any debris and wasl e materia ls thai are genera ted by Empi re , as well as any old fl oori ng or other items thai are being rep laced, unless I ask Ihem nol to do so. Pro blems a nd inquir ies regarding tl1 ls Ag reeme nt should be direcled to the Contractor a t 1-800 -588-2300 . My Promi ses : I promi se to Empi re Ihal (a) I wi ll pro,,;d e Empire wit h reasonab le acce ss 10 my property and the area in which the work is to be periormed, includi ng a ccess to ele ctri ca l outlets ; (b ) 1 Will be resp onsib le for safe ly moving and re installing an y breakable items , extra- heavy furn iture su ch as pianos , s laves , poo l tab les , etc .. and for disconne cting any electrica l appliances in the wo rk area - a ll to ensu re that E mp ire has pro per and safe access to tr.e wo rk area ; (c) If I am removing any eXisting carpeting, I need to remove it a t least 1 day be fore Em pir e does any work. If I have Em pire remove any carpet ing, I ,.vill ie ll Empire whe re 10 dispo se of it. I underst a nd Ihal l should save any unuse d ca rpe t to use for ful ure unforeseen da mage ; and (d) If I ask Empire to leave old materi als tha t are be ing rep laced on my prope rty, I und ers ta nd that Emp ire will no t be responsible for dam age to tho se ite ms, and that thos e items ma y not fu nc tion after Empi re has re placed th em. Warranties /Int end ed Use: I understand tha t I s hould re ad Empire's \"mlte n warran ty, available on til e Empire Today We bsite at W\v .... v.empire -Ioday.c om, for co mpl ete de tails of my wa r~a n ty coverage , a nd that Ihe warranty is ava ilab le fo r my co mp le te re vi 9l.'o' be fore I sIgn Ihl s Agreement. I understand that th e warrant y \v ill no t be effe ctive or e nforce d ... "h ile a ba lanc e due remains outs tan d ing on this Agr eement. L at e Cance llatio n l L ate PaymenUD ef a uit : I und ers tand Ihallila ve 3 busines s days 10 cancel this Agreeme nt , as descri bed on the Nolic e of Rig ht to Cancel. I understa nd that if I want to ca nce l thi s Agreem ent after those 3 days , Emp ire does no t have to all ov.' that. As much as we 50 hope that you'll ne ve r need to can cel your cont ra ct, if Empire does a ll ow that , however , I agree I will pa y to Empire a la te cancellatio n fee of Activity Id : 1-33545 3 504 8 Em p ire /Re s identi a l/M iami 8/6/2 018 Page 11 of 15 EM MRETODAY r t 800·588·2300 15% or as otherwise allowed by applicable law, of the Agreement's purchase price for in-stock flooring and carpet purchased, 33%, or as otherwise 'allowed by applicable law, of the Agreement's purchase price for Window Treatments and 25%, or as otherwise allowed by applicable law for Special Order Flooring. This Cancelation fee may be retamed by Empire from my deposit, and helps Empire to offset the costs of order including scheduling, preparation and operational expenses attributable to my order, and placement of special order product, if applicable. I also agree that if I do not pay Empire any of the money owed when it is due, I can be charged a late fee of 1.5% or as otherwise allowed by applicable law, on the amount owed for each month the money is owed and not paid. I also agree that if my payment is retumed unpaid by my financial institution, I authorize the electronic debit or use of a bank draft drawn from my account in the amount of the payment plus a service charge of $25, or the maximum allowed by law. I also agree that if I default on my promises under this Agreement, and Empire hires an attorney to enforce this Agreement, that I will pay Empire its reasonable legal fees and related costs or expenses, as long as it is legal for me to do that. Delay/Unknown Conditions: I understand that if Empire determines within 30 days of the date of this Agreement that Empire cannot perform the work according to Empire's normal professional standards. then Empire can cancel this Agreement, notify me in writing (or by email if applicable) of the cancellation, and return my money. I understand that some of the things that could cause Empl re to cancel this Agreement would be incorrect pricing, unforeseen structural defects, or unknown preexisting conditions to my property. I understand that Empire is not responsible for structural or other defects in my property, and that Empire's products do not cure those types of problems. I also understand that the work could be delayed by events that Empire does not control, and that is acceptable to me. Some of the things that could cause the work to be delayed would be Acts of God, labor strikes, inclement weather, material shortages, my inability to qualify for or obtain financing, delays by local government authorities in issuing or otherwise approving inspections, permitting, or other required authorizations for the work: Pennission to Photograph: I grant Empire (i) permission to take and have taken before and after photos of my property ("Photos"): and (ii) the worldwide, perpetual and irrevocable right to reproduce, publish, display, exploit, edit, SUblicense, assign and othelWise use Photos without the restriction in all media for any purpose. I represent that I have the necessary authority to grant these rights without consent from others and will indemnify Empire from any claims related to its use of Photos. No Set-Offs or Retentions: I agree that when the work is "substantially complete", I will pay Empire the balance due on the purchase price. I understand that "substantially complete" means the work has been materially finished, functional as intended, and a final inspection, permit, or occupancy certificate, if required, has been obtained. I agree that once I have paid the entire purchase price, if I believe any of the work performed by Empire is defective, Empire will inspect the work and will perform any service I am entitled to under this Agreement and/or warranty. Payment Tenns: I agree and understand that I will pay Empire the balance due on any purchased product at the time Empire begins installation of that product. Total product amount exceeds actual room square footage for seaming, irregular room sizes, nap matching, layout and other factors for proper installation. I agree and understand that if I purchase more than one product from Empire, I will pay the balance due on each product at the time Empire begins installation of each product. I understand that if I apply to fully finance the Contract Price, and full financing is approved, I may request a refund of my deposit from Empire. Security Interest: I understand and agree that Empire may have a security interest in the products Empire is installing in my home to ensure that Empire is paid. I understand that this security interest is governed by the Uniform CommerCial Code and other laws applicable to security interests. I agree that the products are and will remain my personal property, even if the products become attached to my real property. I also agree and understand that in the event that I do not pay Empire any of the money owed when It is due, Empire may have a claim against me that may be enforced against my property in accordance With the applicable lien laws. I also understand that if I finance the work with Empire or a third party, my separately provided financing documents may include a security interest. I understand that I should read those documents closely. AsSignment: I agree that Empire can assign its rights and responsibilities under this Agreement to other companies, but that my rights will not be affected if Empire does this. I understand that sales and installation of Empire's products are provided by qualified and experienced independent contractors. Interpretation of this Agreement: I agree that this Agreement will be enforced under the laws of the state of Illinois. except to the extent preempted by federal law. If any part of this Agreement is determined to be invalid or illegal. then I agree that the rest of this Agreement will still be valid and enforceable. We both understand that this Agreement and any attachments make up the entire understanding between us about the work Empire is doing. There are no other oral or written agreements or representations on which we are relying. We both agree that any change to this Agreement must be in writing and signed by both of us. The paragraph headings contained in this Agreement are for convenience only and will not affect the meaning or interpretation of this Agreement. Condensation and Environmental Conditions: Condensation, which can form on or withi n walls or other surfaces (such as window panes), results from pre-existing conditions in a home and internal or external temperatures. Reducing the humidity in a home will often remedy any condensation problems. I agree that Empire is not responsible for condensation or existing or developing spore or mold growth, which can be the result of condensation. There is conflicting evidence as to whether or not the eXIstence of accumulation of molds (of which 51 there are many different types and varieties) can be harmful to humans. I agree to inspect all work areas prior to construction being Activity Id: 1-3354535048 Empire/Residential/Miami 8/6/2018 Ilnllllllllllllllllllllllllll~llllIllllllnl C:FN 2t:) 19RCII:120215 OR BK 31286 PgS 297-314 (18Pgs) l·i'ECORDEO n 1/1 n !'}I'I:I (J ~ l~ .• f..t:; " .},: ~ARVEY Ru0iN~-~r~R~ 6F·~~G~{ MIAMI-DADE COUNTY~ FLORIDA Single-Family Rehabilitation Program Single Family Grant Agreement SOUTH MIAMI COMMUNITY REDEVELOPMENT AGENCY GRANT PROGRAM AGREEMENT FOR SINGLE -FAMILY REHABILITATION TIDS GRANT AGREEMENT is entered into on this _1_5_ day of November 2018 between the SOUTH MIAMI COMMUNITY REDEVELOPMENT AGENCY ("Agency" or "Grantor"), and Ms.Monigue Clark ("Grantee") whose address is 60 16 SW 63 street and which also has the following Legal Desc ription: FRANKLIN SUB PB 5-34 LOT 78 & E1/2 OF LOT 79 BLK 14 LESS N 17.5 FT T H EREOF LOT SIZE 6188 SQ FT OR 23846 -4 168 0705 4 COC 26 106 -2 34 5 12 20 076 WITNESS ETH: WHEREAS, the Agency has budgeted funds to provide grants benefiting applicants who rehabilitate single-family properties in the Agency's redevelopment area; and WHEREAS, the Grantee will perform the serv ice s required under the Agency's program. NOW, THEREFORE, the Parties agree as fo ll ows: ARTICLE I SCOPE OF SERVICES The Grantee shall prov ide the rehabilitation of single-family properties as shall be approved by the City of South M iami 's building official, and as attached in the Scope of Services labeled Exhibit " I." ARTICLE II CONDITION OF SERVICES The Grantee agrees to the following : a) The rehabilitation shall be limited to the housing of very low, low, or moderate income City of South Miami residents. b) Maintain records including, but not be limited to, the following: I. Informat ion identifying household income, head of househo ld, ethnicity , race and gender, to the extent allowed by law; 2. Other documentation that may be required by the Agency. c) The Grantee shall not, for a period of three (3) years from the execution of this agreement, rent or otherwise conveyor transfer title to the property or any portion of the property. iOtho masfpepe-08 -23-12 d) Allow the Agency and/or City of South Miami officials on the premises and give access to inspect the site and building for code violations. This right may be exercised at any time, and except in an emergency, upon reasonable notice of not less than forty-eight (48) hours. e) The Grantee shall, to the extent permitted by law, allow all necessary personal and fmancial background investigations to be conducted by the Agency. Grantee shall provide Agency with any consents or authorization required by any third party who has such information. f) The Grantee shall not use the Premises, or any portion thereof, or permit the same to be used for any illegal, immoral or improper purposes, nor to make, or permit to be made, any disturbance, noise or annoyance whatsoever detrimental to the premises or the comfort and peace of the inhabitants living within the vicinity of the demised premises. Any violation of this provision within three (3) years from the execution of this Agreement shall result in the entire grant becoming due and payable by the Grantee to the Agency notwithstanding the Agency's agreement to discharge a portion of the debt each year. ARTICLE III TERM OF AGREEMENT This Agreement shall be deemed effective upon execution by both parties, and shall terminate three (3) years from the approved date of November 15,2018. A schedule of completion regarding all exterior and interior improvements is attached as Exhibit "2." ARTICLE IV AMOUNT OF GRANT The Agency shall award the Grantee an amount not to exceed $ 5,000.00 Dollars. Payment shall be made by providing 50% of the total grant amount within forty-five (45) days of the execution of all necessary documents, including this Agreement, and the remaining 50% within 14 days of all required certificates and approvals from any governmental entity of the rehabilitation work and submittal of proof of expenditures. Never shall the amount of the grant exceed the cost of the expenditures relating to the rehabilitation. ARTICLE V DEFAULT For purposes of this Agreement (and the documents referenced or incorporated), a default shall include without limitation the following acts or events of the Grantee, its agents and employees, as applicable and as further detailed below: (1) Failure to comply with applicable federal, state and local regulations and laws. (2) Breach regarding any of the terms and conditions of this Agreement. ©thomasfpepe-08-23-12 Page 2 of6 In the event of a breach, the Grantee shall pay to the Agency the entire amount of the Grant and may exercise any and all rights including the rights to bring any and all legal and/or equitable actions in Miami-Dade County, Florida, in order to enforce the Agency's right and remedies against the Grantee. The Agency shall be entitled to recover all costs of such actions including a reasonable attorney's fees, at trial and appellate levels, to the extent allowed by law. ARTICLE VI AMENDMENTS Any alterations, variations, modifications or waivers of the provisions of this Agreement shall only be valid when they have been reduced to writing, duly approved and signed by both parties. This Agreement contains all the terms and conditions agreed upon by the parties. No other agreement, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or bind any of the parties. ARTICLE VII TERMINATION It is expressly understood and agreed that in the event of curtailment or non-availability of Grant funds, the Agency's obligation to make further payments under provisions of this Agreement will terminate effective as of the time that the Agency determines that funds are no longer available. In the event of such determination, the Grantee agrees that it will not look to nor seek to hold liable the Agency for the further performance of this Agreement and the Agency shall be released from further liability each to the other under the terms of this Agreement. ARTICLE VIII INDEMNIFICATION The Grantee shall defend, indemnify and hold harmless the Agency, its officers, employees and agents, against any claims, suits, actions, damages, proceedings, liabilities and costs (including attorney's fees) arising from or in connection with this Agreement or any contracts the Grantee may enter into with third parties pursuant to this Agreement. The Grantee shall pay all claims and losses of any nature, and shall defend all suits, on behalf of the Agency, its officers, employees or agents when applicable and shall pay all costs and judgments which may issue. ARTICLE IX AUDIT AND INSPECTIONS At any time during normal business hours and as often as the Agency may deem necessary, there shall be made available to the Agency the right to audit and examine all contracts, invoices, materials, payrolls, records of personnel, conditions of employment and other data relating to matters covered by this Agreement. It is further understood that all records and supporting documents pertaining to this Agreement shall be kept for a minimum period of three (3) years from the date of expiration of this Agreement and shall be, to the extent required by law, a public record available for inspection and copying. If any litigation, claim, negotiation, audit or other action involving the records has been started before the expiration of the three (3) OOomasfpepe-08-23-12 Page 3 of6 year period, the records must be retained until completion of the action and resolution of all issues which arise. If during the course of an auctit, the Agency determines that any payments made to the Grantee do not constitute an allowable expenditure, the Agency will have the r ight to deduct/reduce any unpaid invoices or require repayment of those amounts. The Grantee must maintain records necessary to document compliance with the provisions of the Agreement. ARTICLE X NOTICES It is understood and agreed between the parties that all notices that are sent pursuant to and/or in connection with tlus Agreement shall be considered sufficient when made in writing and: mailed by certified mail, return receipt requested , or delivered by electronic (including e - mail or facsimile transmission) or similar means, provided such means creates reasonable proof of delivery; or hand delivered to the appropriate address provided a copy is kept which is stamped with the official stamp of the recipient containing the time and date of delivery, or a copy is kept with the handwritten or stamped name of the receipt and the recipient's signature, and with the time and date of delivery: If to the Agency : Grantee: ARTICLE XI SUBCONTRACTS The Grantee agrees that no assignment or subcontTact will be made in connection with this Agreement without the express written consent of the Agency. ARTICLE XII SEVERABILITY OF PROVISIONS If any provision of this Agreement is held invalid, tile remainder of this Agreement shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of applicable law. ARTICLE XIII PROJECT PUBLICITY The Grantee agrees that any news release or other type of pUblicity pertaining to the Program must recognize the Agency as an entity which provided funds for the project. OOomasfpepe-08-23 -12 Page 4 of6 ARTICLE XIV LIMITATION OF LIABILITY The Agency de s ires to enter into thi s Agreement o nly if in so d o ing the Agency can place a limit on the Agency 's liability for any cause of action ari sin g out of the Agreement, so that its liability will never exceed the agreed swn of $ 5,000.00 Do ll ars. Grantee expresses its willingness to enter into this Agreement with Grantee's recovery froin the Agency for any action or claim arising from thi s Agreement to be limited to $5,000.00 Dollars. Payments under the Agreement shall be set-offs against any award of damages against the Agency. Accordingly, and notwithstanding any other term or condition of this Agreement, Grantee agrees that the Agency shall not be li ab le to Grantee for damages in an amount excess of $5,000.00 Dollars, for any action or claim of the Grantee or any third party arising out ofthis Agreement. Nothing contained in this paragraph or elsewhere in this Agreement is in any way intended to be a waiver of the limitation placed upon Agency's liability as set forth in Chapter 76 8, Florida Statutes. Additionally, the Agency does not waive sovereign immunity, and no claim or award against the Agency shall include attorney's fees, investigative costs or prejudgme nt interes t. .IN WITNESS WHEREOF, the parties have executed thi s Agreem ent by their respective proper officers duly authorized the day and year first a bove written. GRANTEE Print Nam OOomasfpe pe-08-23-12 Page 5 of 6 ATTEST STATE OF FLORIDA COUNTY OF MIAMI-DADE SOUTH MIAMI COMMUNITY RED EVELOPMENT AGENCY B y : ch !!:!ifl J4UJ T he foregoing Grant Agreement was acknowledged before me this ~ay of W ~ 2018,by H.Oal~H C\cvlc , who is /a re pe rSOna ll y known to me , or who has produced the following identification: _____ ----.----.--.-an ~ wif did take an oath. By: _1l~-~--------------- My Commission expires on: ,·i\;;"~. NKENGAA PAYNE II ,.(iIi",.) MY COMMISSION IFF 920975 II "i;~~f EXPIRES: Ocl ober 5.2019 f ..•• P,f..'J..... Btnc!ed Thru Notary Pubk Und e rwrne~ _. ©thomasfpepe·08-2 3-12 Printed Name: t0k~,,-&. }~II.R Title: Notary P tilJ lic, State olFlonda Page 6 of6 Scope of Services Exhibit Ill" To: Honorable Chair and SMCRA Board Members From: James McCants Program s Coordinator Community Outreach Resolution Date: September10, 2018 Subject: Single -Family Rehabilitation Grant Monique Clark A resolution authorizing a single-family residential rehabilitation program funding disbursement in the amount of $5,000.00 for flooring replacement posing safety concerns at 6016 SW 63,d Street. BACKGROUND & ANALYSIS The Single-Family Reh abilitation Program offers grant funding to private single -fa mily homeowners within the South Miami Community Redevelopment Area to increase the quality of the existing housing stock. The program prioritizes applications that ad dres s health, safety and welfare issues or would assist applicants who can at l east afford to carry out rehabilitation activities. Monique Clark is reque sting assistance of grant funding of $5,000.00 for tile replacement . Monique Clark i s concern about the safety of her and the children. Ms. Clark can not address the problem hers elf. The proposed improvement is one of the allowable activities under the program, and Monique Clark does meet the program 's income restriction s. RECOMMENDATION Your approval is r ecom mended . RESOLUTION NO . ..=.:;CR;..;;.:.A~ ____ _ A resolution authorizing a single-family residential rehabilitation program funding disbursement in the amount of $5,000.00 for flooring replacement posing safety concerns at 6016 SW 63 Street. WHEREAS, the adopted redevelopment plan calls for the rehabilitation and preservation of the existing housing stock; and WHEREAS, to facilitate these objectives, the Agency established the single-family and multi-family residential rehabilitation programs; and WHEREAS, efforts have been made to focus on the repair of wall and ceiling damage caused by the rain; and WHEREAS, staff recently received a residential rehabilitation application from Monique Clark, a redevelopment area resident and single woman raising two children; and WHEREAS, the applicant requests assistance to replace tile in her habitat home; and WHEREAS, based on the estimates submitted, the estimate received from AU Superior Home Improvements in the total amount of $5,000 appear to be the most responsive and responsible; and WHEREAS, the Board desires to facilitate goals and objectives of the community redevelopment plan by facilitating housing rehabilitation and preservation initiatives in the SMCRA area. NOW THEREFORE BE IT RESOLVED BY THE COMMUNITY REDEVELOPMENT AGENCY OF THE CITY OF SOUTH MIAMI, FLORIDA THAT: Section 1. The South Miami Community Redevelopment Agency Board authorizes the Agency to enter into agreement in amount not to exceed $5,000 to replace damaged flooring at 6016 SW 63 rd Street, South Miami, FL.; and charging the total amount to Account No. 610-1110-564-99-30 (Residential Rehabilitation Account). Section 2. This resolution shall take effect immediately upon adoption. PASSED AND ADOPTED this _day of September, 2018. ATTEST: APPROVED: SECRETARY CHAIRPERSON Board Vote: Chair Stoddard: Vice Chair Harris: Member Welsh: READ AND APPROVED AS TO FORM: Member Liebman: Member Edmond: Member Jackson: Member Kelly: GENERAL COUNSEL Single -Family Rehabilitation Grant Program Memo Resolution Exhibit 2 • Request for assistance • A schedule of Completion • Estimate from AU Superior Home Improvements Letter of Intent from Ms. Monique Clark IJm asking for assistance in preplacing the flooring in my home located at 6016 SW 63 St. here in South Miami. I have been in my home a long time J some of the floor tile that was originally place :M#ypost a safety hazard. I need help my income is limited. Thank you in advance for your decision to help me. Ms. Monique Clark 1001 kAkWng our NeIghbothood 0 Grear Place to LM. ~ and PIcrf A schedule of Completion Monique Clark is requesting assistance of grant funding of $5,000 .00 for tile replacement. Monique Clark is concern about the safety of her and the children. Ms . Clark cannot address the problem herself. Tile to replace Luxury vinyl tile (LVT) flooring has recently become popular due to its durability, price , and unique-looking surfaces. However, it is made of new or recycled polyvinyl chloride or Pvc. PVC is one of the most environmentally hazardous consumer materials produced. PVC creates large quantities of persistent toxic organochlorines such as dioxins and phthalates and releases them into the indoor and outdoor environments. Both of these chemicals are highly persistent, bio accumulative and toxic to humans and all life . Understanding these factors is important when one is considering how to reduce exposure to formaldehyde in the home. The proposed improvement is one of the allowable activities under the program , and Monique Clark does meet the program's income restrictions. RECOMMENDATION Based on the estimates submitted, the estimate received from AU Superior Home Improvements in the total amount of $5,000 appear to be the most responsive and responsible estimate 1/2 payments to be given to contractor estimated start time 3 nd week of January 2019 Estimated finish time 3 'd week of February 2019 Estimate # 2 A.L.J Superior Home Improvements .tJ4tI' '~. ,. ... i. , .'. ". ~a~ , wtJllttJ! N011V:)01 &or f/lW:lJ ,t\·:1l'''''·~W-gWVlf IIDJJIIOIA ··0£9 8888 -tR-soe;xY::I. CiaOt_-soe:a:H:YO • 88Ol.~:nao' • 8OS~""J,§~SS'lOIYOi:) .~I·VMW .SOSJ.l8XOS·OCl Q" SJIBIIIlStlo..dw, MOll AOJ.IMlnS ·rTlf , ........ McCants, James Subject: FW: Luxury vinyl tile To: McCants, James <JMcCants@southmiamifl,gov> Subject: Luxury vinyl tile OR BK 31286 PG 314 LAST PAGE Luxury vinyl tile (LVT) flooring has recently become popular due to its durability, price, and unique-looking surfaces. However, it is made of new or recycled polyvinyl chloride or PVC. PVC is one of the most environmentally hazardous consumer materials produced. PVC creates large quantities of persistent toxic organochlorines such as dioxins and phthalates and releases them into the indoor and outdoor environments. Both of these chemicals are highly persistent, bioaccumulative and toxic to humans and all life. The process of production and their ultimate incineration in landfills generate some of the most hazardous pollutants known. Formaldehyde levels in a residence may also change with the season, day-to-day, and day-to-night. Levels may be high on a hot and humid day and low on a cool, dry day. Generally as products in the home off-gas formaldehyde over time the levels in the home are reduced. Understanding these factors is important when one is considering how to reduce exposure to formaldehyde in the home. James McCants City of South Miami Programs Coordinator Community Outreach jmccants@southmiamifl.gov Ph 305-668-7237 Fax 305-284-0912 1